Forensic Psychology For Dummies (76 page)

BOOK: Forensic Psychology For Dummies
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Assessing for PTSD years after the event

 

The problem of disentangling causes when PTSD is delayed is demonstrated by the Australian disaster in 1964 when an aircraft carrier collided with a destroyer that then sank. Eighty one people drowned. Over 35 years later, hundreds of people claimed PTSD. Assessing these claims required consideration of the individual’s psychological state immediately after the disaster and what had happened to that person over the intervening years, particularly identifying any other stressors that may have occurred during this time.

 

To make matters more complicated, considerable evidence suggests that a person’s psychological state and make-up before the traumatic event, taken together with the support and other helpful aspects of his lifestyle (or lack of), can have considerable influence on whether or not PTSD occurs and the form it takes. The emotional reactions that the person is having – anxiety, avoidance of people or places and the other general aspects of PTSD – may have been generated by something other than the particular trauma for which the person is claiming. Or these other experiences may have made a mild shock more significant.

 

Studies in the US indicate that about half of the population claims to have experienced some sort of serious traumatic event during their lives. If they experience another such event are the effects magnified or has the person developed coping strategies that makes them less vulnerable? The answer is ‘yes’ or ‘no’ depending on the person.

 

If a person is psychologically stable before the event and in a supportive environment after it, that person is very likely to be able to cope with what appear to be serious traumas. A number of examples exist of studies of children who have lived through wars, in Lebanon or Bosnia for instance, who show no signs of PTSD. They were part of warm and loving families and had no psychological problems before the war. These pre-existing circumstances protected them from PTSD.

 

The various professions that offer help to victims, including clinical and forensic psychologists, draw on a variety of different approaches for treating PTSD and of course people’s reactions to events vary enormously. Any help or support for someone suffering from PTSD therefore has to be adjusted to the person (much of the work on this syndrome emerged out of the recognition that soldiers can suffer great traumas). In general, the following activities are involved in treating PTSD:

 

The nature of the problem and what the client particularly wants help with is identified; for example, fear of particular locations, difficulty of being with other people, intimate relationships and so on.

 

Ways of relaxing are explored with the person, perhaps involving forms of self-hypnosis or other techniques widely used throughout psychotherapy.

 

Victims are encouraged to develop ways of relaxing in relation to particular aspects of their problem, perhaps focusing on particular places or occasions or even back to the traumatic event. Various procedures can be used such as: requiring the client to do the ‘homework’ of trying to deal with some small aspect of the difficult circumstance one tiny step at a time; or guided imagery in which the person thinks carefully about particular stressful circumstances (when calm) and considers how to act effectively in those situations in future.

 

A follow-up is organised as well as addressing the current concerns of the individual to help maintain any improvements in the person’s psychological state.

 

Offering restorative justice

 

Identifying the traumatic consequences of crime and developing accounts of victims’ experiences can imply that they have something close to a medical problem. This approach can lead to them being assigned a clinical label that ignores their unique experiences and ways of dealing with those experiences. They may find themselves being treated as a medical ‘case’ rather than a person, with expectations of how they should act being influenced by general ideas about those sorts of ‘cases’ instead of by the individual person’s behaviour.

 

To counteract this problem, many victims are encouraged by those helping them not to think of themselves as victims, but as survivors of something awful. This change in labelling also gives people confidence to take back control of their lives and not allow the offender to carry on exerting an influence over what they do by continuing to give rise to their fears and anxieties.

 

One way of helping victims feel empowered is by confronting the person who attacked them or stole from them, such as testifying in court or being part of a
restorative justice
process. This approach doesn’t focus on the clinical problems, but on the fact that crime involves a relationship between the offender and the victim and this needs to be dealt with. Restorative justice
emphasises repairing the harm that has been caused by the crime. Going to the essence of the crime and connecting the offender and the victim together can also have beneficial effects on the criminal.

 

Restorative justice gives the victim (or survivor) a significant role in the judicial process and that person’s suffering is placed centre stage. This differs considerably from most legal systems in which the state punishes the criminal and the victim is just one more witness to provide evidence for the state.

 

At the heart of restorative justice processes is offenders acknowledging their wrong-doing and apologising for it. Studies show that this humane acceptance is very beneficial to victims and helps them accept the validity of their own suffering and understand more fully the reasons why the crime occurred, which also helps them come to terms with it.

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